腹部异位嗜铬细胞瘤CT表现与病理对照分析

目的 探讨腹部异位嗜铬细胞瘤的CT表现特征.方法 回顾性分析31例经手术病理证实的腹部异位嗜铬细胞瘤CT表现,对肿瘤的密度、囊变、钙化、界限和强化特征与病理类型和组织成分对照研究.结果 肿瘤位于肠系膜根部9例,腹主动脉旁8例（其中左旁7例,右旁1例）,肾上腺上方3例（其中右侧2例,左侧1例）,肾门外方3例（其中右侧1例,左侧2例）,下腔静脉后3例,肝门区3例,十二指肠壶腹部2例.肿瘤平均6.8 cm×5.6cm（2.7 cm×2.5 cm-18.0cm×11.0cm）.CT平扫：实质部分CT值平均45（32 -58） Hu,坏死囊变部分CT值平均21.5（18-25）Hu;肿块边界清楚28例,不清楚3例;肿块实质部分呈等密度24例,呈高密度7例;肿块中心有不规则低密度坏死区21例;肿块内见斑片状、点状及线状散在分布钙化灶8例.CT增强：动脉期实质部分CT值平均76（47-105） Hu,其中肿块内见纡曲扩张的增强血管影8例;静脉期实质部分CT值平均65（45-90）Hu,其中实质增强部分密度明显下降7例,轻度下降19例,持续强化5例;延迟期实质部分CT值平均56 （42 - 70） Hu,其中实质部分与动脉期及静脉期相比强化程度有不同程度下降26例,持续强化5例.结论 腹部异位嗜铬细胞瘤CT表现具有一定特征性,CT征象与病理类型和组织成分相关,CT表现结合临床可有助于诊断.

CT findings and pathology comparative analysis of ectopic pheochromocytoma in the abdomen

Objective To investigate the CT characteristics of ectopic pheochromocytoma in the abdomen.Methods The CT characteristics of 31 cases of ectopic pheochromocytoma in abdomen proved by surgery and pathology were retrospectively analyzed.The relationship between the density,cystic change,calcification,boundary,the enhancement degree and pathological types and tumor tissue components were studied.Results The tumors location was：9 cases in mesentery,8 cases adjacent to abdominal aorta（7 on the left and1 right）,3 cases above the adrenal gland（2 on the right and 1 left）,3 cases outside the renal hilum（1 on the right and 2 left）,3 cases behind the inferior venacava,3 cases in hepatic hilum,and 2 cases in duodenal ampulla.Tumor size ranged from 2.7 cm ×2.5 cm to 18.0 cm × 11.0 cm（average 6.8 cm ×5.6 cm）.CT plain scan：the CT value was 32-58 Hu for the substantial part（average 45 Hu）,18 to 25 Hu for the cystic necrosis part （average 21.5 Hu）.28 cases had clear boundary and tumor boundary in 3 cases was not clear.24 cases had equal density of the substantial part,7 cases had high density of the substantial part.21 had irregular low-density areas of necrosis in the mass center.8 cases had punctiform,patchy or linear calcification in the mass.Enhanced CT：CT value in arterial phase was 47-105 Hu of the substantial part（average 76 Hu）,among which tortuous expansion within the enhanced vascular shadow of the tumor was found in 8 cases.CT value in venous phase was 45 to 90 Hu of the substantial part（average 65Hu）,among which 7 cases had obviously decreased density in parenchymal enhancement part,19 cases slightly decreased,and 5 cases strengthened constantly.CT value in delayed phase was 42 to 70 Hu of the substantial part（average 56 Hu）,among which 26 cases had less enhancement degree of the substantial part compared to that in the arterial and venous phase,and 5 cases had constant enhancement.Conclusions Ectopic pheochromocytoma in the abdomen has certain characteristic in CT.CT chara